Medicaid

Among the items added to the budget by Senate Republicans was a proposal that would require Medicaid to essentially re-do its procurement process for the managed care plans that want to work with the state. Advocates have said if it’s not removed, it will cause major problems – and especially in the new OhioRISE program for the state’s most troubled and vulnerable kids.

The increase in Ohio Medicaid caseloads could have blown a hole in the new two-year state budget. But the spending plan includes a huge infusion of federal cash for the state’s largest part of the budget, the health insurance program for the poor.

Ohio Gov. Mike DeWine is ready to tackle reforming managed care in the Ohio Medicaid program. 

After three months of declines, Ohio took in 8% more in taxes than the Office of Budget and Management estimated, though much of that is connected to the delay of the tax deadline to July 15. But there was a different kind of growth in the state’s July report that could be concerning.

Ohio’s Medicaid program has rolled out a new tool, the Unified Preferred Drug List, that's meant improve communication between patients, doctors and pharmacists.

Disabled Ohioans are limited on how much they can earn or save and still be eligible for Social Security or Medicaid. But special savings accounts through Ohio’s Treasurer office that will allow them to save without losing benefits are gaining in popularity.

Nearly half of the 25 vetoes that Gov. Mike DeWine issued when he signed the two-year state budget deal with health care and Medicaid, which is the state’s largest program.

Many of Gov. Mike DeWine’s 25 budget vetoes had to do with changes to Ohio’s Medicaid system. And part of that involves the two pharmacy benefit managers or PBMs the state uses as middlemen between Medicaid and pharmacists.

The House budget made no big moves on Medicaid or Medicaid expansion – which is a departure from the last budget, as lawmakers created restrictions and former Gov. John Kasich vetoed many of them. But that may change soon, with a plan to require small premiums and copays from as many as 4 in 10 Medicaid recipients.

Gov. Mike DeWine is revealing more about the wellness initiatives that he wants to implement for the 2.8 million people on Medicaid in Ohio, including the 677,000 in Medicaid expansion. 

As of last Friday, the state has federal permission to require 20 hours of work per week for many non-disabled people on Medicaid expansion.  The state’s Medicaid director has put a number on how many people might be affected – and how much it might cost to put those requirements in place.

The federal government says Ohio can require non-disabled Medicaid expansion recipients to work 20 hours a week unless they’re caregiving, in job training or college or over 50. One state lawmaker is disappointed, because he wanted that age limit to be higher.

Ohio is among 15 states that have asked the federal government for permission to impose work requirements on Medicaid recipients. Ohio’s request would cover people up to age 50, but a state senator has proposed a bill that would go further.

Ohio’s Medicaid Department says a report by the federal inspector general that says the agency paid for medical care for dead people is wrong.

Ohio Medicaid says it will continue to enforce a new rule requiring background checks of Medicaid providers. Some of them say the new practice will cost some good providers their jobs and will worsen tight staffing situations. 

Ohio Medicaid is telling its five managed care plans to sever their contracts with two pharmacy benefits managers, and to work up new deals by the beginning of the year.

It’ll be at least a week before the state will release a full report it commissioned on how much it’s paying its pharmacy benefit managers compared to how much those PBMs are paying out to pharmacies for drugs for Medicaid recipients.

In a little over two weeks, mental health and addiction services for low income Ohioans will be moved into Medicaid managed care. But many behavioral health and family services providers say this huge change is straining their finances. But the group that represents Ohio’s health insurers says the move can’t be delayed.

While the Speaker saga drags on, there are more than 150 bills that are awaiting action in the House. One is a measure that would preserve money for a program that serves more than 800 at risk kids with severe behavioral needs each year.

The state is moving mental health and addiction services for low income Ohioans into Medicaid managed care by July 1, and it’s the biggest and most complicated change the behavioral health system in Ohio has ever seen. But a survey of more than a hundred of those providers shows the redesign is straining their finances and could shut them down.

A group that advocates for low-income people has issued its annual report on the state of poverty in Ohio. 

A healthcare advocacy group delivered hundreds of letters to the state Medicaid office to express their opposition to work requirements for certain Medicaid recipients. 

State lawmakers want more information about the billing practices of companies that handle prescription drug benefits for millions of Medicaid recipients in Ohio. That's because they’re being accused of using the pharmacies they operate to drive smaller pharmacies out of business.

A program that helps working families in Ohio afford health care for their children with serious medical conditions is in limbo right now. 

The Trump Administration is clearing the way for states to attach work requirements for Medicaid. The announcement has sparked outrage among health care advocates. This can mean some changes for the state’s program.

The state auditor’s office says it found more than $10.5 million in overpayments to Medicaid providers in the last year.

Time is running out for Congress to approve more funding for the Children’s Health Insurance Program before the money dries up. It's operated by states and Ohio has a plan for the program known as CHIP in case Congress doesn’t act.

The Trump Administration has signaled it’ll give flexibility to states when it comes to how they operate their Medicaid programs. That will likely open the door for Ohio to implement a controversial measure.

For the first time since lawmakers required it in the budget, Gov. John Kasich’s administration made a trip to the Statehouse to ask a panel of legislators to release hundreds of millions of dollars to fund Medicaid.